Loading...
HomeMy WebLinkAboutP22774 Hwy 801SDAVIE COUNTY HEALTH QEPARTMEIiT SEPTIC TANK PERMIT Dat e:?-2_'�-� �— ), mer/Occupant _ �� To: �, ��., u"` .� z - S_� Address /, •C>r� �r cfr ;� :1 �. �i Address s l Building Contractor rz c: L^--..c-�Z Address Cal. 01 Manufacturer's Name .�-1J-� Addresses L r No. of lines fes. Width 3 L in, Total length ft. No. sq. ft. - , -4 Type of filter material Total tons used ..3,�Z, Minimum REquirements: [louse Trailer Tank cap. 800 Sq. ft. line 400 Two-bedroom house 800 600 Three-bedroom house 900 900 No one shall install a septic tank in Davie County without a permit from the Health Offic or his agent. Date of Final Approval , ��_ y= Signed: %U SAhitarian I hereby certify that the above septic tank has been install,,ed according t s ecificatior Signed:L Septi c Tank Con actor Note: Make sketch of disposal system on back of sheet and mail to Davie County Health Center, Box 57, Mocksville, North Carolina 27028. �� d VETERANS ADMINISTRATION INDIVIDUAL SEWAGE DISPOSAL INFORMATION (Tris information must be submitted for Individual Sewage Disposal Systems on proposed construction cases, or existing construction not previously occupied.) NAME OF VETERAN #Qy —_ ff' PROPERTY ADDRESS vu.h <fl, R � ©© 4 LOT NO. BLOCK NO. WATER SUPPLY: PUBLIC INDIVIDUAL WELL lr COMMUNITY PERCOLATION TEST RESULTS: To be made in accordance with MPS 1103-10.3 by a Licensed Engineer or Qualified Sanitarian. Percolation Rate (Record Rate in Minutes Per Inch) Test hole #1 z d Test hole #2 �p Q SUBSOIL CONDITIONS: Indicate subsoil conditions to a point at least 6 feet below the finished grade of the absorption trenches. WATER TABLE ELEVATION: Indicate distance to ground water. 30 Remarks: Date • C Da5� VA Form 6.7 (31 April 1965 These tests were made by: Signature r r r Title Address S� FRA